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Original Article

Predictors of Health-related Quality-of-life Change after Total Hip Arthroplasty

José M. Quintana¹, Antonio Escobar², Urko Aguirre¹, Iratxe Lafuente¹ and Juan C. Arenaza³

(1)	Unidad de Investigación, Hospital Galdakao-Usansolo-CIBER Epidemiología y Salud Pública (CIBERESP), Barrio Labeaga s/n, 48960 Galdakao, Vizcaya , Spain

(2)	Unidad de Investigación, Hospital de Basurto-CIBER Epidemiología y Salud Pública (CIBERESP), Bilbao, Vizcaya , Spain

(3)	Servicio de Traumatología-Ortopedia, Hospital de Basurto, Bilbao, Vizcaya , Spain

Received: 9 October 2008 Accepted: 15 April 2009 Published online: 2 May 2009

Abstract Various parameters have been considered as possible predictors of health-related quality-of-life outcomes after THA in patients with hip osteoarthritis. We hypothesized the preintervention health status is the main and more homogeneous predictor of changes of the different aspects of health-related quality-of-life outcomes, mental health status has an important influence on results, whereas other sociodemographic or clinical factors had only a punctual influence. All patients who fulfilled the selection criteria completed the Medical Outcomes Study SF-36 and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) before and 6 months after the intervention. Seven hundred eighty-eight patients completed the questionnaire before the intervention and 590 completed it (74.9%) at 6 months. The preintervention score in each SF-36 and WOMAC domain and the SF-36 mental health domain predicted changes after the intervention. Female gender, having comorbidities, contralateral hip osteoarthritis, or back pain predicted less improvement on some SF-36 domains. Older age, the presence of contralateral hip osteoarthritis, or back pain predicted less improvement on some of the WOMAC domains. Preintervention health status, measured by the WOMAC or SF-36, and mental health status uniformly predicted health-related quality-of-life changes, whereas some clinical parameters predicted some domains. SF-36 and WOMAC seem to be appropriate tools for predicting THA outcomes.

Level of Evidence: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

One or more of the authors (JMQ) have received funding from grants from the Fondo de Investigación Sanitaria (98/001-01 to 03) and the thematic networks, Red IRYSS, of the Instituto de Salud Carlos III (G03/220).

Each author certifies that his or her institution has approved the reporting of these cases, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participating in the study was obtained.

This work was performed at Unidad de Investigación, Hospital Galdakao-Usansolo-CIBER Epidemiología y Salud Pública (CIBERESP).

José M. Quintana
Email: josemaria.quintanalopez@osakidetza.net

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